Makindo Medical Notes

Vaccination Guidelines for Older Adults and High-Risk Patients in the UK

The NHS recommends specific vaccinations for older adults and individuals with underlying health conditions to help prevent serious illness from common infections. These guidelines cover flu, pneumococcal, and shingles vaccinations, focusing on those aged 65 and over, individuals with chronic conditions, and those undergoing specific treatments.

Flu Vaccine

• The flu vaccine is highly recommended and available free of charge on the NHS for:
  • All adults aged 65 and over.
  • Individuals aged 6 months to 65 years who have chronic conditions such as respiratory diseases, heart conditions, kidney disease, diabetes, and neurological conditions.
  • People with weakened immune systems, including those undergoing cancer treatment with steroids, chemotherapy, biological drugs, or immunotherapy.
  • Pregnant women, healthcare workers, and those living in long-term care facilities.
  • Close contacts of individuals on the NHS shielded patient list to help protect vulnerable populations.
• Quadrivalent Flu Vaccine for Immunotherapy Patients: Patients undergoing immunotherapy should receive the quadrivalent flu vaccine, specifically designed for those under 65, regardless of their age, due to their increased vulnerability.

Pneumococcal Vaccine

• The pneumococcal vaccine protects against infections like pneumonia, meningitis, and sepsis caused by pneumococcal bacteria.
• It is recommended for:
  • All adults aged 65 and over.
  • Individuals with chronic health conditions, including respiratory issues, chronic kidney or liver disease, diabetes, and weakened immune systems.
  • Anyone with a cochlear implant, CSF leaks, or those who have had their spleen removed.
• Types of Pneumococcal Vaccines: Two types are used in the UK – the Pneumococcal Conjugate Vaccine (PCV13) and the Pneumococcal Polysaccharide Vaccine (PPV23). Those aged 65 and over generally receive a single dose of the PPV23, while PCV13 is more commonly used in younger individuals at higher risk.

Shingles (HPZ) Vaccine

• The shingles vaccine is recommended for adults aged 70 to 79 to reduce the risk and severity of shingles and associated complications.
• Because the shingles vaccine is a live vaccine, it is NOT safe for immunocompromised patients, including:
  • Individuals on cancer treatments such as steroids, chemotherapy, biological drugs, or immunotherapy.
  • Patients with conditions or treatments that suppress the immune system, such as advanced HIV infection.
• New Non-Live Shingles Vaccines: Non-live shingles vaccines, like Shingrix, are becoming more widely available for immunocompromised individuals but may require additional eligibility assessments.

Additional Recommendations

• Tetanus and Diphtheria Boosters: A booster dose is recommended every 10 years, particularly for older adults and those at higher risk of exposure due to occupation or injury.
• COVID-19 Booster: An annual COVID-19 booster is recommended for older adults, high-risk individuals, and healthcare workers.
• Hepatitis B Vaccine: Recommended for those with chronic kidney or liver disease, healthcare workers, and individuals with increased risk of exposure.

Vaccination provides essential protection for older adults and high-risk patients against severe complications from common infections. For tailored vaccination guidance, patients should consult with their GP or local health service.